Form 5500 · Employee benefit plan · NEEDHAM, MA
XENON PHARMACEUTICALS USA, INC.
The filing calls this plan XENON PHARMACEUTICALS USA INC, HEALTH AND WELFARE BENEFIT PLAN.
XENON PHARMACEUTICALS USA, INC. of NEEDHAM, MA insures health, dental, vision, life and disability coverage for its employees, per Schedule A of its Form 5500. Its broker of record is MARSH & MCLENNAN AGENCY LLC (NE). Coverage is written through BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. and 4 other carriers. The plan's most recent policy period ended in December.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 81-4576210 · plan 501 · plan year 2025, filed Aug 12, 2026
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How this plan is funded
Fully insured as reported
The filing reports medical coverage through an insurance contract on Schedule A, and no money paid for benefits by the plan itself.
Benefits declared on this filing
Also declared: other welfare.
Declared benefits are the plan’s own line 8b codes on Form 5500. “Not on Schedule A” means no insured contract for that line appears on this filing. That usually means the benefit is self-funded, or it sits under a different plan number.
Persons covered is the count the carrier filed for that policy at the end of its policy year, and it can include dependents. Participants is the plan's own count at the start of its plan year. The two count different people, so a covered figure can be larger.
Plan brief
Schedule A lists 5 insured contracts covering health, dental, vision, life and disability; the largest, with BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC., covers 433 people.
Reported premium across the insured contracts is $4,537,692, with $61,809 in disclosed broker commissions — about 1.4% of premium.
The most recent policy period ended in December, and the plan year ends December 31. Group contracts typically renew on that annual cycle.
MARSH & MCLENNAN AGENCY LLC (NE) is the broker of record on 1 of the 5 contracts; the rest name a different broker or none.
5 carriers appear on the filing, including BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC., SUN LIFE ASSURANCE COMPANY OF CANADA, DELTA DENTAL OF MASSACHUSETTS and VISION SERVICE PLAN. BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. writes the largest contract by premium.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | Health | 433 | Jan 1, 2026 | $3,846,463 | $38,660 |
| SUN LIFE ASSURANCE COMPANY OF CANADA | Life, Disability | 174 | Jan 1, 2026 | $369,725 | $12,995 |
| DELTA DENTAL OF MASSACHUSETTS | Dental | 464 | Jan 1, 2026 | $271,628 | $7,656 |
| VISION SERVICE PLAN | Vision | 165 | Jan 1, 2026 | $44,921 | $1,755 |
| ZURICH AMERICAN INSURANCE COMPANY | — | 174 | Jan 1, 2026 | $4,955 | $743 |
Premium and claims on this contract
BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC., contract 4960768. For the contract year on this filing, the carrier reported $3,846,463 in premium earned and $3,279,642 in claims incurred. Dividing one by the other gives 85%.
- BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC., contract 4960768 reported $566,821 in retention.
Retention is what the carrier kept of the premium after claims, as reported: administration, commissions and other charges.
Only experience-rated contracts report these figures, so most filings leave them blank.
Covered = persons covered at policy year end, as filed on Schedule A for that policy — often certificates or one class, not the whole plan. Premium = the filing’s own premium/charges figure; “—” means not credibly reported.
Administrator and service providers
The plan administrator is from line 3a of the main form. We publish company names only.
Other plans filed by this employer
How this plan compares
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